Statins Reduce More Than Cholesterol

Statins for coronary heart disease may lower testosterone

(RxWiki News) Statins are effective and popular cholesterol-lowering medications. But they also have some possible side effects, including memory loss and high blood sugar. Now lower testosterone may join the list.

Statins may help fight heart disease by lowering "bad" (LDL) cholesterol. These medications may reduce death rates and cardiovascular events such as heart attack.

Research has also found these medications may increase the risk of diabetes, but may also lower testosterone levels as well.

"Learn the side effects of your Rx."

C. Mary Schooling, PhD, a researcher with the School of Public Health at the University of Hong Kong in China, collaborated with other scientists at the University of Hong Kong to compile data from previous studies on statins and their effect on testosterone levels.

In five trials involving 501 men taking statins, testosterone levels decreased by an average of 0.66 nmol/L (a measure of nanomoles per liter).

In six trials of 368 women, statins lowered testosterone by 0.40 nmol/L. Normal testosterone levels for males are 10 to 38 nmol/L, according to Yale School of Medicine. Women have a normal testosterone range of (0.52 to 2.4 nmol/L).

“The clinical significance of this reduction in testosterone with statins is difficult to gauge,” said the authors.

Investigators found erectile dysfunction was a rare side effect of statins perhaps because statins have beneficial effects on cardiovascular function that would counteract changes from the testosterone.

The authors noted, however, large changes in testosterone and libido can occasionally occur with statin use.

In their report, the authors raised the question of whether the change in testosterone level “plays a role in statins’ effects on health.”

“Whether reducing testosterone enhances or impairs the protective effects of statins on cardiovascular mortality needs to be determined urgently, because it could enable the development of enhanced statin based treatments,” concluded the authors.

Statins are a class of medications that work in the liver to prevent the formation of cholesterol. In addition to lowering LDL cholesterol, statins may have modest effects on lowering triglycerides (blood fats) and raising HDL ("good") cholesterol, according to the American Heart Association (AHA).

Mark Newberry, PharmD, owner of Tarrytown Pharmacy in Austin, Texas, said "When I read the study I found a few things that stood out to me.  First, it was a fairly small sample size and, two, it was retrospective."

"If I were taking one of the statin drugs, which have been proven to have an incredible benefit on reducing mortality, I would keep taking it.  If, in a few years, we have multiple studies that show truly negative outcomes, then I would consider talking to my doctor about discontinuation of therapy."

The AHA says most side effects of statins are mild and generally go away as your body adjusts.

Statins available in the United States include atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor, Altoprev), pravastatin (Pravachol), rosuvastatin calcium (Crestor) and simvastatin (Zocor). 

The study was published February 28 in BMC Medicine. One of the authors has received research funding from MedImmune Inc., and consults for Crucell MV.

Review Date: 
March 11, 2013